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DGTL Voices with Ed Marx
AI in Healthcare: Revolutionizing Patient Care (ft Dr. Junaid Kalia)
00:27:05
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- [00:02]
A
Welcome to Digital Voices, where healthcare and life science leaders explore the real work behind transformation. This podcast is about people, leadership, and the conversations that move healthcare forward. Now your host, Ed Marks, welcome to.
- [00:18]
B
Another edition of Digital Voices. Thank you for listening. You've made us number four in the world under technology. Thank you so much. We appreciate it.
- [00:27]
C
And you thank.
- [00:27]
B
And it's because we have great guests like Dr. Junaid Kalia. Junaid, welcome to Digital Voices.
- [00:34]
C
Thank you so much, Ed, for inviting me. Really appreciate it.
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B
No, this is going to be great because what you're doing is just fascinating and we're going to jump into that here in a second. You and I first met less than a year ago, actually. We were doing a book signing with Chris Ross in my home and you came out and it was great. We got a chance to interact and people can't see this, but Jenae's actually lifting up the book right now with our signatures in it. And I really appreciated you making the trip out, but it's like, wow, this guy's pretty cool. Doing some cool things. And then we started a podcast together along with Dr. Harvey Castro called Signals and Symptoms Podcast. What's cool about it is it's live podcast. I mean, you can also get the recording, obviously, but we go live every Wednesday, 7am Central Time, so we'll put all that information in the show notes. So it's great. But Junaid, the most important thing that we ask on Digital Voices is what songs are on your playlist.
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C
So I love Journey. That is one of the. I'm the biggest fan as far as that is concerned. My Wake up song is from Fort Minor, remember? And then of course I have a bunch of rock bands from Pakistan and India. The biggest one is Janu that I listen to. And yeah, daily workout routine goes with the rock songs.
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B
I love it. So what is your life message or mantra? Are there sort of words that guide you that you live by?
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C
If you save a life, it is as if you save a life of all mankind. That is my mission in life. That's why I wake up in the morning, read the first thing. It is my prayer. It is our both the Old Testament and the Quran. And believe it or not, it is in most holy books from Hinduism, Buddhism, et cetera, verbatim.
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B
Very cool. Love it. We'll add it. We actually have a listing of all of our. Not just a playlist for all of the songs, but also of all the life quotes. So tell us a little bit about you. Like who are you? What's your story? Where were you born?
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C
So I was born in Karachi, Pakistan, but we are essentially from India, which was before the Partition. It is a town near Gujarat. And I don't know if you're familiar with Gujaratis. Gujaratis are essentially businessmen. As a matter of fact, I never wanted to be a physician. My older sister wanted to be a physician. And then what ended up happening is I went to my dad. Hey, I got into a great business school and also got into a great medical school. So my dad says that, you know what, I'm going to teach you business. No MBA is going to teach you what I'm going to teach you. So why don't you do medical school? Because, you know, it's a different thing. You might like it. And then your mom wants you to be a doctor and everything. And that led to my love for neurology, the neurosciences and the brain, which of course I'm going to talk about how the journey towards neurons, which are brain, and artificial neural network, which is AI, and then how essentially it was built on the basis of neuroscience. And that's how I developed my AI. Basically interest. And then one by one, one thing led to another. We actually were offered Green card as a whole family because we applied and I came to us trained at UT Southwestern for my fellowships residency at St. Louis University Hospital. And most importantly, actually, I did two years of research work under Osama Zaydad, which is my mentor at University of Wisconsin. So long journey, but very fruitful.
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B
Yeah. And I know you're married. Were you married previous to coming to the United States or after?
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C
Oh, no, I found my wife in Chicago. Okay. She is actually my best friend's wife's cousin. So she introduced us at a wedding ceremony, which is, by the way, classic Indian, Pakistani introduction. And then, yeah, she was perfect. I mean, she herself is. Has a master's in health management. And she actually is amazing. And I am grateful to her to stick around with double three fellowships. And then of course, entrepreneurship, which is more insane than, you know, neurocritical care Fellowship.
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B
Yeah, that's cool. Was there a pivotal moment in life that fundamentally changed your trajectory?
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C
Three fundamental movements. One was actually not doing business and doing medicine, which is becoming a identity of a healer. And as you know, most physicians do very strongly identify themselves from their work perspective, which is again, one huge shift when I actually started medic school and started loving it. Before that, believe it or not, I used to, even right after, right outside high school, I was a professional teacher. And not only I was a professional teacher, I actually hired other teachers to teach. So I already had a business going organic chemistry. That's what I used to teach in the MCATs, by the way. So that was one pivotal shift from business to really concentrating on the healer side and then from healer to coming here and understanding the research side of things and actually understanding how vastly important clinical research as a, as a backend, but research in general, which lacked significantly in my mind. So essentially identifying myself from a physician to physician scientist and then lastly going back to essentially becoming an entrepreneur as an identity, but more importantly an AI sort of expert in healthcare. So those were three pivotal shifts in my mind that going from pure business to physician scientists, physician scientists to entrepreneurships. And I use entrepreneurship as a different category than business. I mean running a clinical practice is a business, haircut salon is a business. But entrepreneurship is very different.
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B
You alluded to the fact that you had chosen neurology. Go a little bit deeper like why did you get into it? Because that's going to lead into save life AI, which I want to talk about as well.
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C
Again, I'm a fairly spiritual person. I wish I was a little more religious, but I'm not. And I hopefully somebody's graces actually passes me through. The most important thing that is important from an upbringing perspective is from my parents to be ethical. So we're very, very grounded by the way. Not the whole family is not even that religious, FYI. But we were grounded in ethics, which has nothing to do with religion by the way. I mean religion starts when ethics end. So. But the idea was that you need to have a set of core beliefs that you operate under. And then even if somebody doesn't exist up there, it doesn't matter. You operate that you have, you are answerable. Because at the end of the day. So when, when you're reviewing these things in the world of consciousness and going up to that, what I realize is that, that the operating team needs to be fully conscious and available. That's. Yeah. And then when I was reading through this, what I realized is that most of even biggest religions are text based essentially. And then when the admin. Because we were doing AI for vision like image analysis, stroke and everything. But the minute I saw ChatGPT 2 and then 3 and that is even before the 3.5 and everyone understood it and we were in the AI game because of the vision part, then I realized that more so it's like a light bulb moment that we are really in a strange territory. I'm just going to be honest, it's a very strange Territory. I mean it is. And the way I defined it is a non human intelligence, quote unquote, an alien intelligence. Right. So at that point in time this technology basically completely shifted. Essentially really at the core shook me up. Because if computer is generating text and we actually thought that humans are the only one who understand language because she literally talks to someone. How do you differentiate a human and an animal? Because they communicate. Right theory beautifully communicate. Dolphins, dogs, they communicate way better. As a matter of fact humans, when they do need clarification and communication, they do not use language. That's why airport has signals of hands, paddles and everything because we miscommunicate with language. So what I'm saying is that the communication is a different problem. But language poetry songs that you just started with has a such a deep connection with being an identity of human. And when it goes to machine. That honestly shook me to the core. I was like okay, I need to understand is it really true or fake? And then I realized that it's neither true nor fake and it's a wrong way of thinking, which I'm not going to discuss. But the idea was that this technology is really shaping how you define humans, let alone how you define AI.
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B
So you mentioned sort of this third identity, entrepreneurship. So you did start this company, SaveLife AI. So tell us the origin story.
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C
So origin story is very simple. I'm a stroke physician. I came to us, we wanted to go back and serve the countries because by the way, my whole medical school fee was $500 for five years. $500. So I was on a government scholarship. I said, you know, I should do give something back. So I we used some of these applications here from great companies by the way, I'm not going to name them, but they are fantastic people that developed us. And I asked them, hey, can we take these technologies back? But they were saying that it was not possible or it was extremely expensive. So there was no business case because it was more of a philanthropy of course. So I said, I mean I would rather build it myself. So I actually spent half a million dollars on building sort of this backend. And of course when you're doing it in the start a lot of money is wasted because you're learning. So I ended up building it and then the whole idea was making it free for all low and middle income countries. My thought was that I am actually trained as a director of NeuroICU with 26 beds ICU back in an advocate. I don't know, 26 or 12. I know I forget but I Was director of neuro icu. And what I realized about any human interaction, look, I'm just going to be very honest and people are going to hate me saying it. Medicine is easy, but taking care of humans is the hardest one, right? I mean diagnosing in air is very easy, right? You have uti, you have uri, you have this, you're going to give steroids, you're going to give this, you're going to give, you know, antibiotics, antivirus. That's so freaking easy. Taking care of the patient is the hard part, right? So that all depends on two things. Number one is workflow and number two is actually understanding, you know, and everything into a first principles way and dissect the whole problem. So as a neurointensivist when you are sitting there, you have to understand who's going to get choppered in, who's going to get ambulance, then who's going to stay at a peripheral hospital, who's going to get, you know, where are we going to start another neurology service? We're going to, you know, enhance through virtual care where we're not going to enhance what you care. So when we went through this whole decision process and learning and all of that, taking courses, then when I set up this company and the software and everything, I set it up from a first principal thinking. So everything was design, development, was document first approach, which is very different people develop and then document. So mine was document first approach. And then I realized man, I can get an FDA and this is becoming a very good business model. And then one thing led to another. So one of the the technical things that I had to actually go for was to put it on an edge device because of the low income and low resources. It's a USB C battery pack. It is basically a nanopack on which my model works for bleed in the brain. So this is one of the things we did. So people actually came up to me that how the hell are you making it free for low income countries? And I said, well this is the reason because I have it in edge, I don't need to upload download infrastructure costs can be down. And then people gave me orders like hey, can you make breast cancer detection, breast mass detection? Because we want to put it in Ethiopia, Uganda, Nigeria or other places. And then of course once you think of a product release or everything, you do all of your back end research, a business plan and everything. And every time there's a business plan in terms of, you know, being able to make it available to us as well, those are the technologies we're bringing through FD approval and us and some of these, you know, solutions that we bring just models out. We don't even get regulation because again business side is very different than regulatory side and all of that. So we have to manage that. So the journey was simple. Do things in an organized fashion, document first. And once you do that you're going to realize that, you know, there are more possibilities in the future and that learning is always safe so you don't have to repeat everything, et cetera, et cetera.
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B
Yeah, no, that's great. So tell us some success stories to date.
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C
So interestingly as I said, that number one success story is that now I go anywhere investors are actually lining up. So that's a very good validation that you have something of value. Number two is that that we have implemented this in multiple places in low income countries and they are actually utilizing it. Number three is that while we were doing this we learned the large language model portions and we were able to enhance both the vision model and the language model and now we are developing multiple fast iteration of it. As a matter of fact we have our own sort of pre trained LLM for just writing FDA applications. So we are now iterating very fast. We actually have signed contracts significant here in US now officially. So we are on track for breaking even by end of March. And then of course we have significant expansion opportunity in the winter region with our partners hearts medical solution, they're out of Doha Qatar. Honestly, the one line I would say is that start crawling, you will, you will learn how to walk and you will eventually learn how to run and things open up. I mean you have been amazing important advisor for me, Harvey Castro, et cetera. And then once you get into that model of continuous learning and for me especially was, you know, I am actually very open. There are some mistakes. So what everyone does mistakes. As a matter of fact, investors are very appreciative of that. That if you have known blind spots and you know how to correct them or at least ask for help. Yeah, that is extremely important. So for me it is keeping. Keep walking, start crawling. At least you learn how to walk and run.
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B
Yeah, that's great. It's a great success story. Where do you think SaveLife AI is headed? What's next, like in terms of development or the potential of what could be in the future?
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C
So as I said, what is the real moat? When I teach, let's say entrepreneurship to someone and then I'm going to ask you like okay, define a moat and that's something that I learned from you and is first DOI value and investment, which has two factors, soft ROI and hard roi. You always calculate that that's number one. And it could be time savings, it could be money savings, it could be money generated and it could be early diagnosis and detection. So that's always concentrate on the DOI part. So that's something that we sort of always review first when we are looking at save life AI in terms of future projections, how we're going to build different products. But the second biggest ROI moat that people don't understand, and that's where clinicians need to really take high stakes into these development processes is because that we are merging. So I was vice president of clinical strategy of B1, which is a telemedicine company. So now I have AI, I have telemedicine and I know how to move people from a neurointensivist to stroke to different tertiary centers. So we are developing essentially a user experience for all of critical solutions in which it could be managing patient journey through artificial intelligence end to end, which includes voice, reasoning and vision agents. And that is what saves life is the AI is going to capture the biggest market and it could be tele, icu, telestroke or again acute coronary syndrome. So. So I have personally worked significantly hard in developing that user experience too because that's the key thing to understand how the patient journey connects with the provider's journey. And that is where the biggest mode in AI will be, in my opinion, in the future as we democratize Frontier foundation models.
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B
No, that's super. We will put information about SaveLife AI in the show notes for people who are interested in pursuing more. Let's talk about leadership. Where do you go or what do you do when you feel creativity drained? Because you're a super smart person, obviously, and you're also very creative and innovative. But those times where you're not just having that free sort of flow of thinking, what do you do?
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C
Oh, running a startup and doing a clinical work, of course, my chances are very low. One is music, as a matter of fact. My escape is essentially I drive with a volume blast for 20 minutes. I'm fully refreshed, come back. I don't pray that much, but I mean somewhere between meditation and prayer, you can say there is always a recharge possibility. But interestingly, I wake up at 2, maybe 3 in the morning. I start my work, clinical work and everything. But I'm a very good napper and I think that really re energizes me significantly. So I can literally take a nap for 10 minutes and micro naps or something. Recharge, move on. So those are my three ways to recharge for creativity. Leadership is interesting and it's also changing in the age of AI because how do you have a marketing team that you can run with one person? Should you. So essentially what, what I realized is that, that there's a C suite. This is not like one person, it is a C suite and the CEO or the founder is on top of that. So my initial problem was not leadership because fairly user experience with neurocritical care director, tele director of Tele ICU and then of course working in different organizations. That was fairly done. It was what was hardest for me is to be what we call leadership training for my C suite, which was the hardest part because it is very different that that perspective changes and more importantly perceptions change. So that's hard.
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B
Yeah. Well, well, what are one or two things that you have learned the hard way along your journey?
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C
Things do at times take time. You just have to be patient. Actually that would me say that, you know, patience is extremely important. And that's where my wife comes in. She always reminds me again and again that anything worth doing in life at least takes seven years. Medical school, four years, three years of residency. I mean even in any other career in your life, you where you come in out, it takes seven, seven years. And I know it's just a real odd situation with this VC funds and all of that. And my investors asked me, oh well, he's saying three years. And I said go, yeah, go with him. I'm not gonna, I'm. I'm just going to be very honest and clear. Anything worth doing in life requires time and patience. And then the second big of course is with the patience is resilience. That's where the second important thing is. And that's what I keep teaching my leadership now. I think the biggest, the best book I word is word grit. If you have, if you're going to spend money behind a founder, which is again early Stage Industries, essentially the founder because co founders even leave and everything. But the point, the definition of grit is essentially doing hard work persistently for a number of years and that's great without basically tying out and everything. And that's I think is my biggest lesson that I realized. And I keep telling physicians, entrepreneurs that you need to be patient because you know, for you, and by the way, just to give you an example, the average physician lifetime income is going to be $25 million with a $5 million savings at the end. Maybe it's just, of course, some people do move better and all of that at the end of the day. And if you're thinking you're going to make a startup for the $50 million or $100 million or $500 million without medical school, residency, fellowship, like, come on.
- [21:34]
B
So anyways, yeah, let's end by going back almost to the beginning. Was there anything that your parents forced you to do when you were a kid growing up and you maybe rolled your eyes, but now that you look back, you're glad they did it?
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C
Oh, yeah. I was essentially a kid with adhd, supposedly. And my mother was extremely strict and I'm extremely grateful to her for that. But once I did. But she understood because, you know, when I, when I commit, I commit. I mean, there's a small story in the first grade, actually I failed on the midterms because there was a midterms. And then my mom was like, are you crazy? I said, don't worry, I'll, I'll, I'll be fine. And then I, I came the first in class at the end because my mom was like, dude, what is the problem? And it just was a little switch that goes off. And that's very important for parents who understand in this age of, you know, extreme distraction and beautiful distraction with these AI images and everything that it is, you just need to refocus patiently and everything. So that's number one. And the second thing that my dad taught me is the word value itself. Anytime you would have a discussion, he would have, okay, what is the value? And he would say, okay, what is the time commitment? What is the money commitment? What is this commitment? And 10 is identity. If I have to, any purchase is concerned. And he would have, yes. Like, I would do courses. Is that, Look, Junaid, you, you have, you can't do all the courses. Just define value, value, value. So I'm very grateful for my dad on that regard, being a business minded person and you know, everything he has to do with calculation that he instilled in me that always calculate value and then always wear different hats. Time value, money value, opportunity, cost as a value, all of these things. So my parents were amazing and they, they did set me straight. I'm just being honest.
- [23:27]
B
Yeah, yeah, no, I love that. And you're still in touch with them. Like you, you have regular, regular interactions.
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C
If I don't call a day, which is, by the way, I've been calling them, and my wife is like, what kind of person are you? Have to call your mom every day. But anyways, I do, I do call my mom every day practically. And if I don't, she would like what happened and she would call my wife first because she knows I may be in the meetings or something. And then like. Yeah. And we go over weekend and then we all brothers and sisters get together. My parents are all about grandkids at that time.
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B
Yeah, yeah.
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C
And all of the grandkids were there and they're just having fun with the grandkids. So they're not gonna even chat with me or anything. So I specifically make sure that I alone and not my brothers or sisters are not allowed either. Like every Wednesday or so 12 noon, I take them for lunch outside. Then the reason behind it is my mom loves cooking and she gives it, wants to give it, but I bring it back home. But I take my parents out for lunch so that I can hear directly from them.
- [24:27]
B
Yeah, you're a good man. I really appreciate you taking the time and sharing with us about your journey. All from speaking of journey, your favorite band and then your life mantra and message, you know, all around Save a Life, which is also the name of your, of the company. And and then sharing with us about your roots in Pakistan, India and coming over to the United States. And I liked how you talked about your three identities as a healer, scientist and entrepreneur and then talked about your career. You talked about SaveLife, AI, all the great things and how it's saving lives all around the world and then your whole journey into entrepreneurship. And I like what you said about medicine is the easy part. Taking care of humans is a lot harder whenever you get humans involved. There's something about that. And then what I like we talk a lot about leadership. But the thing I picked out the best Junaid is it's okay to nap and it's important. So you're a neurologist, so we know it's fact how important napping is. And then you also talked about grit, the need for grit and being patient. You know, the seven year mark, the wisdom from your wife, what did we miss? Or anything you want to double down on. I'll give you the last word. Yeah.
- [25:36]
C
Now you know, AI people are talking about it and this is sort of an odd situation. And we're calling it as an AI bubble. This is a circle between Nvidia, OpenAI, AMD, Microsoft and all of that. And this has been what, the history of any technological advancement. Everything comes out of a dot com bubble like Amazon, Google and everything. And then if you really look at the history you're going to see that Google has acquired what, 27 to 100 companies. So have Microsoft. So I've just. So I'm going to tell you right now that it scares the shit out of me now personally because it never used to believe me. There's a, there's a click that happened this year because we have reasoning models, we have degrees. So my last thing would be that please learn artificial intelligence, how to use these new tools on a regular basis. And number three is that I think healthcare may be the most important and fascinating and exciting application of artificial intelligence. So I would recommend that everyone should teach their kids, learn them, develop those skills actively because the future is the era of AI.
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B
Dr. Junaid Kelia thank you for being guest on Digital Voices.
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C
Thank you so much.
- [26:51]
A
Thank you for listening to Digital Voices. We hope today's conversation sparked ideas, reflection and connection. Subscribe on YouTube, Apple and Spotify podcasts so you don't miss an episode.